Event Review: Rethinking Trauma as a Global Challenge
• Ulm University
• German Research Foundation (DFG)
• German Center for Research and Innovation (GCRI)
Trauma is the leading cause of death for people under the age of 45. Even if not fatal, road, workplace, or sports accidents can cause problems in interpersonal relationships, work productivity, and overall well-being. How do we approach trauma today? In which ways are we able to improve treatment and the healing process? Do we need to rethink our understanding of trauma in general?
On February 17, 2016, the German Center for Research and Innovation (GCRI) together with Ulm University and the German Research Foundation (DFG) hosted a panel discussion in New York with experts from both sides of the Atlantic to present cutting-edge research in the field and to address these questions. Three German medical researchers joined one U.S. counterpart from the University of California, San Francisco, and a Canadian health expert from McGill University in Montreal for the discussion.
Former N.F.L. player Sean James also shared his view on trauma. He kicked off the evening by calling for more dialogue and education on traumatic events that occur in sports. Conditions such as C.T.E., Alzheimer’s, and even early deaths of former athletes worry the former football player. James provided insight into the culture of football, in which toughness is necessary for advancing one’s career. He described the sound of “getting your bell rung” – the act of moving other people away just by using one’s head – like a pipe that is being hit with a hammer that would usually ring for about 5 to 30 seconds in one’s ear. To change the way we look at sports and to diminish the risk of severe, permanent damage that trauma can cause, James advocates for better education.
Prof. Dr. Florian Gebhard, who works at the Collaborative Center for Trauma Research at Ulm University, defined trauma as a complex process in the body that requires a special clinical approach. “Trauma is not just having pain or having a broken bone, but [rather] it’s a disease that influences the whole body,” he said, advocating for a more holistic approach. The statistics he presented were striking: 5.9 million deaths worldwide per year are caused by some sort of injury and the economic damage totals 30 billion dollars annually. This means that infectious diseases, such as AIDS, in fact, have less of an impact than trauma, according to Gebhard. Trauma research is one of the key focus areas of Ulm University, which has projects like a trauma registry database and 52 established trauma networks all over Germany.
Ted Miclau from the School of Medicine at the University of California, San Francisco, presented his institution’s approach, which seeks to integrate trauma treatment into the entire hospital experience. Miclau provided an overview on progress in the field, dividing it into three main areas: basic science, clinical research, and health services. An aging population and long-term hospitalizations especially pose a concern to researchers. Miclau also raised the issue of health economics and policies. Avoiding health complications would be very appealing to insurance companies and could relieve tension from an ever-growing and increasingly expensive healthcare system. Databases that include information about doctors’ performances could also have a positive effect on the accountability and reliability of clinicians and thereby improve treatment. Miclau also questioned the economic impact of technology and how to enable more inexpensive projects to balance the development of increasingly expensive technologies.
Edward Harvey, Chief of Orthopedic Trauma Research and Professor of Surgery at McGill University, spoke primarily about technological advances in trauma treatment and whether disruptive and groundbreaking technologies exist. He explained how technologies must be consumer-ready at low prices in order to become interesting for the healthcare industry. Referring to nanotechnology in particular, he cited examples of bone reconstruction and neuro cell treatment to target cancer cells. From his experience, there is “no doubt that sensors will come to medicine.” The sensor technology in the wellness sector represents a 70 billion dollar market and will change how people do medicine.
Prof. Dr. med. vet. Anita Ignatius also spoke on behalf of Ulm University. She noted how scientists had previously focused on single injuries in healthy organisms. This, however, is inadequate as trauma can induce a full body reaction and trauma victims are not always young and healthy. The impact of multiple traumas is rarely investigated and mechanisms are not sufficiently understood. She therefore also recommends taking a more holistic approach.
Ulm University holds the leading position in Germany in trauma treatment as well as research and was recognized with a grant from the German Research Foundation (DFG) to establish a collaborative research center. The Center will enable closer collaboration between the physical and psychological trauma research centers at Ulm University.
Ignatius’s colleague Dr. med. Miriam Kalbitz is a young investigator at Ulm University. She described the attractive opportunities for young researchers in her department, including start-up funding, initiatives like the “Trauma Track” program, and special support programs for female scientists that demonstrate the university’s commitment to attracting young research personnel.
A Q&A between the panelists and audience ensued. When asked whether James would allow his children to play football, he pointed out that having the information about the potential damage it can cause to your body makes one think twice about it. He criticized the lack of medical care available for former professional athletes and stressed the need for greater transparency regarding the health risks.
Miclau explained how nearly everyone is affected by trauma, which is the number one cause for years of life lost – more than cancer and cardiovascular diseases combined. Initially, trauma research was just looking at biology and biomechanics. Now researchers are linking physical and psychological trauma. By 2020, trauma-related disorders will be the largest expenditure globally with trauma spending in the U.S. already surpassing cardiovascular diseases as the largest national expenditure today.
While responding to the audience’s questions, Harvey noted that Germany is the number one supporter of nanotechnology in Europe with major companies having identified that by 2017, there will be seven trillion sensors in use, which equates to thousands of sensors per person. Nonetheless, Harvey advocated for more funding towards trauma research on both sides of the Atlantic.
Other questions revolved around specific new technologies and the potential dangers they present, ways to overcome interdisciplinary boundaries, and the use of data and governmental cooperation to improve trauma treatment, especially with regards to wounded veterans. The evening’s moderator, Ruth Priscilla Kirstein, concluded the discussion by asking the panelists what they thought would be the “next big thing” in trauma research. A reception in the German House followed during which panelists and audience members had the opportunity to continue the lively discussion about the greatest health risk of our time.